MELISSA NELSON
Fresno,CA
Summary
Certified Pharmacy Technician experienced in retail and mail-order pharmacy, insurance verification, and claims resolution. Improved efficiency in handling claims and enhanced customer satisfaction through strong analytical skills and attention to detail. Focused on delivering timely resolutions and contributing to team training and inventory management.
Overview
1
1
Certification
24
24
years of professional experience
Work History
Insurance Verification Specialist / Patient Care Coordinator FEP
Alliance Rx Walgreens + Prime
Irving, TX
11.2017 - Current
- Resolved insurance verification and prescription coverage issues, facilitating Medicare and Medicaid claim adjudication.
- Maintained patient records and supplies, ordered and audited medication inventory, and provided training and support to enhance team effectiveness.
- Verified patient insurance benefits for specialty pharmacy prescriptions at Alliance Rx Walgreens Prime.
- Reviewed payer eligibility, coverage details, and plan restrictions for prescription processing.
- Initiated prior authorization requests with insurers and prescribers for medication access.
Help Desk Specialist / CPhT
Hospice Pharmacy Solutions
Richardson, TX
01.2015 - 01.2017
- Resolved prescription rejections related to plan restrictions, unmatched cardholder IDs, prior authorizations, and medication cost limits, ensuring timely access to necessary medications.
- Coordinated medication approvals and patient admission information with hospice managers, collaborating with pharmacy nurses and pharmacists to facilitate seamless patient care.
- Answered hospice pharmacy support calls for patients, caregivers, and clinical staff.
- Resolved help desk tickets for prescription, delivery, and account questions.
- Documented service requests in pharmacy support systems and call logs.
Senior Pharmacy Technician
Express Scripts (formerly Wellpoint)
Fort Worth, TX
01.2006 - 01.2015
- Resolved complex insurance rejections, ensuring proper authorization and adherence to coverage restrictions, which facilitated timely patient access to medications.
- Assisted pharmacists with prescription issues, processed faxed prescriptions, and corrected patient and provider information while providing training to new employees.
- Processed prescription orders using Express Scripts pharmacy systems and claims workflows.
- Reviewed medication profiles for accuracy, safety, and insurance coverage requirements.
- Prepared, labeled, and packaged prescriptions following pharmacy policies and HIPAA rules.
Pharmacy Technician
Walgreens Pharmacy
Bedford, TX
01.2003 - 01.2006
- Processed prescriptions and refills while managing medication inventory and ensuring accurate handling of Medicare, Medicaid, CHIP, private insurance, and workers' compensation claims.
- Prepared and verified medications for dispensing under pharmacist review while maintaining and troubleshooting dispensing equipment.
- Dispensed prescriptions according to Walgreens Pharmacy procedures and pharmacist direction.
- Verified patient profiles, allergies, and medication histories in Walgreens systems.
- Processed insurance claims and resolved billing issues at Walgreens Pharmacy.
Education
Tarrant County College
Arlington, TXSkills
- Insurance Verification
- Prior Authorizations
- Prescription Processing
- Claim Rejection Resolution
- Insurance Adjudication
- Government insurance programs
- HIPAA Compliance
- Medication Inventory
- Pharmacy Software Applications
- Data Entry
- Patient and Provider Communication
- Pharmacy Math
- Microsoft Windows
- Word
- Excel
- Team Leadership
- Hospice Pharmacy Support
Personal Information
Title: CERTIFIED PHARMACY TECHNICIAN | INSURANCE VERIFICATION | PHARMACY HELP DESK
Certification
Pharmacy Technician Certification Board (PTCB) | June 2026–June 2028
Timeline
Insurance Verification Specialist / Patient Care Coordinator FEP
Alliance Rx Walgreens + Prime
11.2017 - Current
Help Desk Specialist / CPhT
Hospice Pharmacy Solutions
01.2015 - 01.2017
Senior Pharmacy Technician
Express Scripts (formerly Wellpoint)
01.2006 - 01.2015
Pharmacy Technician
Walgreens Pharmacy
01.2003 - 01.2006
Tarrant County College